Search Results (85,136)

This study presents a systematic bibliometric analysis and critical review of assessment indicators and multi-criteria decision-making methods for rural energy systems from 2010 to 2025. It examines the evolving definitions and regional variations in these indicators and methods. The research hotspots of rural energy systems have shifted from basic rural electrification to multi-dimensional assessment indicators and hybrid multi-criteria decision-making methods. The assessment indicators for rural energy systems demonstrate a marked imbalance, dominated by economic and technical dimensions. Specifically, economic evaluations for rural energy systems frequently utilize net present cost and levelized energy cost, shifting from static capital comparisons to comprehensive lifecycle assessments. Meanwhile, loss of power supply probability is identified as the primary inherent constraint among technical assessment indicators for rural energy systems. Geographically, assessment indicators for rural energy systems priorities exhibit significant divergence. Developing regions prioritize basic power supply and affordability, whereas developed regions focus on grid stability and market risk resilience. In addition, environmental evaluations for rural energy systems remain fixated on carbon emissions. Developed nations emphasize global climate benefits, while developing nations focus on localized dividends like indoor air quality improvement. Critically, despite an increasing focus on rural livelihoods, social indicators remain systematically marginalized in rural energy systems, leading to the neglect of local requirements and increasing technical risks. The field of rural energy system assessment is advancing toward multi-criteria decision-making indicators. Future methodologies must integrate robust, dynamic adaptive mechanisms that respond to evolving developmental priorities in order to effectively address inherent data scarcity and complex socio-economic uncertainties of rural energy systems. Full article

Leukocyte telomere length (LTL) is shortened in adults with type 1 diabetes (T1D), but less data is available concerning pediatric cases. Multiple factors affect LTL, namely genes, epigenetics, environmental factors, oxidation, and psychological stress. Children with T1D and their families experience chronic stress. This study aimed to investigate LTL in children with T1D (n = 35) aged 6–13 years old, in comparison to age-matched healthy counterparts (n = 35), and assess any correlation of LTL with perceived stress. Relative LTL (rLTL) was assessed through real-time qPCR. Morning serum cortisol, high-sensitivity C-Reactive Protein (hsCRP), and glycated hemoglobin (HbA1c) were measured. Children completed the validated questionnaires “Stress in Children” and “Pediatric Quality of Life”. Parents answered the “Perceived Stress Scale”. Children with T1D had a lower rLTL (p = 0.02) compared to age-matched healthy controls, higher hsCRP (p = 0.031), and a lower estimated quality of life (p = 0.01). RLTL was found to be lower in females with T1D (p < 0.001) and was positively related to the ‘gender–social support’ factor (p = 0.002) and diabetes duration (p = 0.045), adjusted for children’s age, parental age, and sociodemographic characteristics. These pilot findings indicate early emergence of shorter rLTL in T1D, pointing to a sexual dimorphism pattern. Insights into preventing LTL shortening in pediatric T1D can be gained from large-scale studies examining the impact of gender and social support. Full article

Social media engagement drives both individual behavior and content dissemination, yet traditional analytics often reduce interactions to simple counts, obscuring the complex structures underlying user activity. In the highly competitive digital landscape, understanding how users interact with content is crucial for businesses aiming to optimize social media campaigns and maximize return on investment (ROI). Traditional engagement metrics, such as likes and shares, fail to capture the underlying structure and dynamics of user behavior. This study investigates the latent patterns of engagement by combining topological data analysis (TDA) with behavioral clustering across 100,000 posts on multiple platforms. Using persistent homology and k-nearest neighbour graphs, we reveal a primary bifurcation between Active (validation-focused) and Passive (consumption/propagation) users, nested four-strain substructures, and over 650 significant $H_1$ loops indicating recurring feedback cycles. Active users exhibit strong cluster cohesion and high engagement rates, while Passive users contribute broadly to content diffusion with slightly higher loop counts, highlighting distinct functional roles in social media dynamics. These findings provide a principled framework for targeting content, reinforcing feedback loops, and leveraging hub posts to amplify engagement. By linking topological structure to behavioral patterns, this work advances both the theoretical understanding of digital interaction and the practical design of more effective social media campaigns. Full article

Recent studies have shown a growing prevalence of autism spectrum disorders, accompanied by heightened concerns about the impact of misinformation on autism stigmatization, shaping public perceptions of autism. With the increase in autism cases worldwide, it is critical to have sufficient understanding, knowledge, and awareness about autism, especially among the autism information seekers. This study focused on the progression of autism information over time and investigated the relationships among various factors such as autism knowledge, awareness, stigma, misinformation, cultural beliefs, and social norms. Employing a two-phase research design approach comprising systematic literature review and survey, the study indicated an overall increase in autism knowledge and awareness, although it revealed disparities in certain ethnicities and areas such as genetic testing. Despite advancements, stigma was found to persist. Survey findings validated these observations, emphasizing the necessity for heightened autism awareness and the continued presence of stigma. Furthermore, the survey demonstrated that knowledge influences awareness, whereas cultural beliefs and social norms directly affect autism misinformation. Importantly, the study highlighted how cultural beliefs, and misinformation can hinder accurate understanding and knowledge of autism, potentially exacerbating stigma. By employing evidence-based approaches, this study offers comprehensive insights into autism, enriching the broader literature on the subject. Full article

Higher education institutions (HEIs) play a central role in fostering sustainability competencies to address environmental challenges. Within Education for Sustainable Development (ESD) and Sustainable Development Goal (SDG) 4 frameworks, universities must cultivate not only knowledge but also attitudes and behaviours promoting environmental responsibility. This study examines environmental attitudes as sustainability learning outcomes among undergraduate students, analysing differences by gender, age, and discipline in six Andalusian universities. Sustainable Education is defined as an approach integrating environmental, social, and economic sustainability dimensions into teaching to develop active competencies for sustainable development. A cross-sectional survey (n = 1471) used the validated CASEM questionnaire (see previous validation studies) to assess environmental knowledge, environmental education knowledge, and pro-environmental behaviour. The results show significant differences: women outperformed men across all dimensions, students aged over 25 exhibited stronger profiles, and Education Sciences students outperformed Engineering students. A persistent knowledge–behaviour gap emerged, especially in technical fields. These findings reveal curricular inequalities in sustainability integration. Mandatory, discipline-specific ESD—particularly in engineering—may help bridge these gaps and enhance uniform learning outcomes. By employing a multidimensional instrument and stratified sample, this study offers robust evidence of structural disparities, informing policy for equitable Higher Education for Sustainability. Full article

Background: Physical activity (PA), physical fitness (PF), and motor skills (MS) play crucial roles in overall health and well-being, particularly in early childhood, when habits that affect future health are formed. Methods: This study, involving 299 children (150 boys, 149 girls, mean age 6.9 ± 0.96 years), explored the variance explained by external factors such as socioeconomic status (SES), body composition (BC), sex, and geographical location on motor-related physical fitness (MRPF) and health-related physical fitness (HRPF) in children. Using a variety of assessments, including demographics, anthropometric data, BIA, ActiGraphs, the 20 m shuttle run, 10 and 20 m speed tests, and test items from the Körperkoordinations test für Kinder (KTK) and the TGMD-2, a multiple stepwise regression analysis using SPSS (v 28.0) identified the associated factors. Results: The variables tested show modest explained variance for HRPF, MRPF, and MS, with the largest cumulative explained variance of 26.4%. The explained variances for MRPF and MS were lower (medium to small) than the significant, medium-to-large, explained variances for HRPF. Body fat percentage (BF%), moderate-to-vigorous physical activity (MVPA), parental education and income, and BMI emerged as substantial contributors to HRPF, explaining 12.1% to 26.4% of the variance. Sex, BF%, and quintile status were the most influential associated factors for MRPF, and for MS, BMI and sex emerged as the strongest contributors. Conclusions: These findings underscore the importance of holistic approaches that consider individual factors, such as MVPA, body composition (BC), PA levels, sex, and broader social and economic contexts, to promote children’s well-being. The study emphasises the need for comprehensive strategies to address the multifaceted associations with children’s physical development. Full article

Sustainable development results from the harmonious integration of economic growth, social equity, and environmental sustainability. Building on available risk analysis capacities, this study employs risk perception as a diagnostic tool to evaluate the adequacy of decision-making regarding environmental sustainability in vulnerable human settlements under a changing climate in the Dominican Republic. Using the perceived risk profile approach and a specially designed questionnaire, the research explores issues related to climate change and sustainability, targeting a population composed of decision-makers and professionals engaged in risk assessment. The findings reveal a systematic underestimation of risk across most perception variables, as well as a generally low collective risk perception. The study’s methodological framework enables the identification of proactive measures to strengthen knowledge and performance among decision-makers and stakeholders involved in advancing sustainable development in Dominican human settlements. Full article

Population aging intensifies the need for built environments that support healthy and independent living while reducing preventable risks. This integrative review examines how architectural design, safety measures, and corporate security can function as an integrated, layered system for creating age-friendly environments across public spaces, housing, and intergenerational community settings. Drawing on a systematic search of literature published between 2010 and 2026 across databases including Scopus, Web of Science, Google Scholar, and PubMed, supplemented by international standards and policy documents, the review analyses how universal design principles, injury prevention strategies, and governance routines intersect to sustain mobility, reduce harms, and protect data, devices, and operational continuity. The findings indicate that gaps in any layer, such as inaccessible layouts, poorly maintained safety systems, or weak cybersecurity, can undermine overall effectiveness, compromise trust, and affect older adults’ autonomy. The COVID-19 pandemic further exposed these interdependencies, accelerating smart technology adoption while exacerbating digital inequality and social isolation, particularly in rural settings. This review concludes that age-friendly environments require not only barrier-free architecture and proportionate safety measures, but also robust governance structures that ensure accountability, lifecycle maintenance, and responsible data practices. Integrating these three domains provides a foundation for resilient, trustworthy, and health-promoting environments that enable older adults to remain active, socially connected, and secure. Full article

Artificial intelligence has become one of the major driving forces for business change in the modern business world. This study focuses on the link between marketing strategies, such as social media marketing and content marketing, and business sustainability, and on the role of artificial intelligence as a mediator for SMEs in Nablus. This research used a survey design based on 373 employees working for SMEs mainly based in Nablus. This research used exploratory and confirmatory factor analyses to validate the measurement model, and structural equation modeling and SPSS v.25 PROCESS macro analysis to verify the proposed relationships. This research found that marketing strategies positively link to business sustainability; the strongest direct link was found for content marketing. Artificial intelligence also significantly mediated the relationships between social media marketing and content marketing and business sustainability. This research highlights the importance of incorporating artificial intelligence into marketing strategies to improve the effectiveness of marketing strategies and support decisions for enhancing business sustainability for SMEs in emerging economies. Full article

Background: This study aimed to estimate the prevalence and associated demographic factors of autism spectrum disorder (ASD) in children aged 3 to 6 years in Bahrain, as well as to identify co-occurring developmental disorders. Methodology: The study sample comprised 500 children who attended eight health centers across four governorates (Group A) in Bahrain. A second group (Group B) consisted of all children who completed their diagnosis at the Child and Adolescent Psychiatric Unit for ASD from June 2023 to May 2024 to identify associated developmental disorders (n = 232). Group A mothers were interviewed using the M-CHAT-R. For Group B, we used children’s files, the General Intelligence Scale (Stanford-Binet), the M-CHAT-R, the CARS, Conners’ Form, and the Zarit Burden Interview to assess family burden. Additionally, a file review was conducted to determine the presence of intellectual disability (ID) in Group B cases. The Conner-3 Short Forms Test was administered to all cases aged 6 years or older (n = 64), and family burden was assessed using the Zarit Burden Interview Scale for reachable cases (n = 176). Results: Group A findings indicated an overall screen-based/at risk prevalence of ASD of 2.6%, with a higher prevalence in males (1.6%) compared to females (1%). In Group B, there was a78% prevalence of ID and a 17.2% prevalence of attention-deficit/hyperactivity disorder (ADHD). The study also found that the impact of having a child with ASD on the family varied based on the nature and severity of the disorder or disability, with moderate to severe burden reported at approximately 38%. Conclusions: The prevalence of ASD among young children was notably high, particularly among males. The most common comorbidities were ID followed by ADHD. The family burden associated with ASD was significant, with more than one third reporting moderate to severe burden. These data are essential for informing health education and social service planning. Full article

Background: Long-term diabetes mellitus may precipitate severe complications, including cognitive dysfunction. Existing research has shown that diabetic cognitive impairment (DCI) in rats is characterized by memory deterioration and a disordered arrangement of hippocampal cells. The Shichangpu–Xiyangshen herb pair (SX) effectively improved the pathological changes induced by DCI. However, the role of SX in regulating the physiological and behavioral responses to DCI remains unclear. Methods: We sought to determine the small-molecule metabolites of cerebrospinal fluid (CSF) and delineate the pathways to elucidate the potential mechanism of the effect of SX in the treatment of DCI by metabolomics strategies, focusing on key mechanisms. Behavioral assessments were conducted on DCI rats and the rats treated with SX, as well as an evaluation of neuronal morphology in the hippocampal region. Metabolomics was used to analyze biomarkers in cerebrospinal fluid at different time points during the development of DCI, to uncover the underlying core mechanisms of DCI, and to investigate the regulatory effects of SX on these core mechanisms. The mechanisms of SX on DCI were investigated using quantitative reverse transcription polymerase chain reaction, immunohistochemistry, Western blot, and ELISA. Results: The Morris water maze (MWM) and social interaction test results revealed that SX administration effectively counteracted cognitive impairments in rats with DCI while simultaneously diminishing pathological damage in the CA1, CA3, and DG hippocampal regions. Further analysis showed that SX restored the significantly reduced levels of IL-8, ROX, and TNF-α, and reduced Aβ plaque formation (as indicated by APP and BACE1 protein expression). Simultaneously, SX markedly ameliorated arachidonic acid metabolic disorders in DCI, including significant reductions in arachidonic acid (AA), PGE2, and LTB4 and reduced expression of COX-2 (PTGS2) and 5-LOX (ALOX-5). Conclusions: Our findings indicate that SX effectively counteracted cognitive impairment in rats with DCI by inhibiting AA metabolism through both cyclooxygenase and lipoxygenase pathways, thereby minimizing neuronal damage. Full article

Background: Maternal dietary avoidance during breastfeeding of infants with food allergies (FA) is common, but its impact on growth and development is unclear. Methods: This prospective cohort study enrolled infants aged 4–6 months who were mainly breastfed from the child health care clinic of Children’s Hospital of Chongqing Medical University, Chongqing, China. The participants were classified into a group with clinically diagnosed FA and a non-food allergies (NFA) group. To analyze avoidance extent, the FA group was stratified into high (≥5 types) and low (<5 types) avoidance subgroups based on the median number of avoided food categories. Outcomes included anthropometric Z-scores and ASQ:SE-2 social–emotional scores at 12 months, analyzed using Generalized Estimating Equations. Results: High avoidance mothers comprised 50% of the FA group. Compared to the high avoidance group, the non-FA group showed significantly better linear growth (β = 0.84, 95% CI 0.38–1.30, p < 0.001). Weight and head circumference showed no differences. High avoidance was associated with higher ASQ:SE-2 scores versus both the low avoidance and non-FA groups (p < 0.001), indicating greater social–emotional concerns. Conclusions: Extensive maternal dietary avoidance was associated with suboptimal linear growth and higher social–emotional risk scores in infants with FA, underscoring the need for integrated nutritional and developmental monitoring. These findings warrant cautious interpretation given the exploratory nature of this single-center study. Full article

Mining plays a key role in economic development but faces increasing challenges in reconciling sustainability with social expectations in the territories where extractive activities operate. In regions with a strong mining presence, incorporating community perceptions has become essential for guiding sustainable development strategies. However, systematic evidence to prioritize these dimensions at the local level remains limited. In this context, the present study identifies and ranks critical sustainability factors from the perspective of communities located near mining projects in the Coquimbo Region, Chile. To structure the decision problem, the Analytic Hierarchy Process (AHP) was applied. This multi-criteria decision-making (MCDM) method integrates qualitative and quantitative judgments through pairwise comparison matrices processed using Expert Choice software, based on a hierarchical structure of criteria, subcriteria, and decision elements associated with social, economic, and environmental dimensions. The results indicate that the criterion with the highest global priority was “Improvement in health, social cohesion, and quality of life” (36.3%), followed by “Economic development” (20.3%) and “Local development and social participation” (15.7%). Among the most prioritized actions were “Construction of health facilities” (15.5%), “Promote the hiring of local labor” (8.7%), and “Protection and continuous monitoring of aquifers” (6.3%). Sensitivity analysis confirmed the stability of the model, suggesting that the proposed framework can support the systematic incorporation of community perceptions into the planning of mining sustainability strategies. Full article

The COVID-19 pandemic has renewed interest in proximity tourism as a driver for culturally sustainable local development. Against this backdrop, this study examines the Province of Latina, Italy, evaluating the potential of proximity tourism flows originating from the Metropolitan City of Rome to reduce the socioeconomic and infrastructural disparities that affect the provincial territory. Using a multi-stage quantitative framework, the research identifies key determinants of municipal attractiveness and assesses the structural relationships between tourism activities, economic development, and demographic trends. Results reveal a clear spatial polarization: while coastal municipalities successfully leverage natural and cultural assets for development, they increasingly face challenges related to overtourism and gentrification. Conversely, marginalized hilly and mountainous peripheries remain underdeveloped despite their high heritage value. Empirical evidence suggests that while proximity tourism does not directly drive demographic growth, it acts indirectly as a catalyst by stimulating economic development. The study concludes that proximity tourism can foster territorial cohesion and socioeconomic resilience only when coupled within integrated strategies that improve accessibility, valorize peripheral assets, and keep the added value of tourism embedded within host communities. These findings offer actionable insights for policymakers aiming to transition toward more inclusive and culturally sustainable tourism models in the post-pandemic era. Full article

Background: Conducting research in emergency departments and critical care units is crucial for improving patient management through evidence-based practices. Healthcare professionals and researchers in the field of traumatic brain injury (TBI) have a moral and legal obligation to inform patients before conducting any diagnostic test or therapy as part of a clinical study. However, challenges and barriers to conducting research in these high-pressure environments must be acknowledged. Shall the pathway to obtain informed consent in TBI-related research be revisited? We sought to map literature, identify gaps, and clarify the bioethics that should be followed in TBI-related research. Methods: A Scoping review was conducted to identify the obstacles and challenges investigators encounter in clinical and translational TBI research, with a specific emphasis on informed consent and regulatory impediments that often serve as bottlenecks or rate-limiting steps for participant enrollment and overall study success. This review used google scholar and Midline from inception to 2025. Results: Patients with TBI or their surrogates may be unable to provide informed consent within limited therapeutic windows. Despite international regulations and national laws, restrictions on obtaining consent are often criticized as ambiguous in certain situations. Furthermore, the fast-paced, emotionally charged atmosphere in emergency settings poses a risk of delaying crucial research interventions. There are accepted alternatives to informed consent, such as proxy consent, deferred consent, exceptions from consent, and waivers of consent, which are ethically and socially acceptable and compliant with regulations. However, these alternatives are underutilized or may be abused in some cases. Conclusions: This review calls for clarifying and modifying arbitrary regulatory restrictions on research and streamlining the Common Rule. Scientists should also share their innovative solutions to strike a balance between ethical considerations and the minimization of research barriers. Full article